HomeMy WebLinkAboutSupplemental Attachments - 5/20/2019City of Waterloo
Finance Committee Preliminary Draft Invoice Report
For May 20 2019 Approval
Finance Committee Accounts Payable Open Invoice Report Total
As of Friday, May 17, 2019
EFT Transactions:
1,220,506.14
GATSO 26,172.00
Bankers Trust 9,040,498.15
Wells Fargo 3,995,180.00
Add: Wellmark Weekly Claims
259,067.77
Workers Compensation Issued by TPA
Housing Authority Housing Assistance EFT's
Housing Authority Housing Assistance EFT's
Payroll
14,541,424.06
15, 996.76
783.00
Bill Payment Total - Monday, May 20, 2019
14,558,203.82
Payment to Council members or related entities:
TRAVEL REQEST
CITY OF WATERLOO
NAME(S) AND POSITION(S):
Kent Shankle, Director
DATE:
5/9/2019
FINANCE DEPT.
LINE ITEM USED
FY ;2oI? BUDGETED
EXPENDED YTD
THIS REQUEST
LEFT AFTER TI -115
REQUEST
DATE
Original - Clerk/Finance
STAFF ONLY
04' Ate 42(d /346,
/ow ce-
did2,-
Soo
515-s 19
Cosy - De•artment
NAME OF CLASS / MEETING:
Transport of exhibition/program supplies
DEPARTURE DATE:
5/18/19
DESTINATION: Rhinelander WI
DEPARTURE POINT
IF NOT WATERLOO:
RETURN DATE:
5/20/19
DATE(S) OF MEETING:
5/18-19/19
PURPOSE OF TRAVEL/TRAINING:
Travel to pick up Haitian art from the WCA collection which was recently on exhibition at ArtStart in Rhinelander WI.
Travel will also include a stop in Minneapolis MN to pick up building supplies and clay for ceramics programs (a previous
trip had been scheduled to pick up clay order but clay was not available due to production problems). Travel is supported
by a grant from the Iowa Department of Cultural Affairs.
WILL TRAVEL REQUIRE ADDITIONAL PERSONNEL:
YES
NO
COST $
METHOD OF TRAVEL:
X CITY VEHICLE
AIRFARE
DEPARTING FROM:
ESTIMATE OF COST:
$75.00 LODGING
MEALS
REGISTRATION
$225.00 MILEAGE/FUEL
TOTAL FOR ALL: $ $300.00
TAXI
PARKING
AIRFARE
MISC/TOLLS
I BELIEVE THIS TRIP SERVES A PUBLIC PURPOSE
AND IS NECESSARY AND BENEFICIAL TO THE
CITY OF WATERLOO
DEPART
/
LENT HEAD
( (9
PRIVATE VEHICLE
26STG.OSG 010 26
BUDGET LINE ITEM: 4265 1346
YES NO
GRANT REIMBURSABLE
x REQUIRED CERTIFICATION
YES NO
TOTAL: $
PER PERSON
I APPROVE THIS TRAVEL REQUEST
wybt.-i-vizacy
MAYOR
DATE DATE
K:\Shared Goodies\Forms\Travel Request Form January 2010
Ater .c/9l/5�
CITY OF WATERLOO, IOWA
CITY ATTORNEY'S OFFICE
715 Mulberry Street • Waterloo, IA 50703 • (319) 291-4327 Fax (319) 291-4286
May 20, 2019
Mayor Quentin Hart and
City Council Members
City Hall
Waterloo, IA 50703
Dear Mayor Hart and Council Members:
I have examined the bonds filed with the City Clerk/Auditor's Office up to the
close of business on May 20, 2019.
Of the 6 bonds submitted,
shown on the attached list.
Very truly yours,
were approved and was rejected, as
DDR.ZHOEFER
Waterloo City Attorney
DRZ:sda
CITY WEBSITE: www.cityofwaterlooiowa.com
WE'RE WORKING FOR YOU!
An Equal Opportunity/Affirmative Action Employer
BONDS FOR COUNCIL APPROVAL
May 20, 2019
RIGHT OF WAY CONSTRUCTION BOND AMOUNT $15,000.00
X98382 ALLEN NIEDERT dba NIEDERT CONSTRUCTION AND REMODELING WATERLOO, IA
RLI0513265 B.C. CONSTRUCTION, INC. CEDAR FALLS, IA
--- CROSSROADS PROPERTY MAINTENANCE '—,4".e'-').4 WATERLOO, IA
1A5162189 JONI STEEN WATERLOO, IA
RL10618722 LARRY A. RUST dba LARRY AND COMPANY, INC. RAYMOND, IA
--- W150316379 PROFESSIONAL CONCRETE WATERLOO, IA
SureTec Insurance Company
CONTINUATION CERTIFICATE
Bond No.: 3398382
Principal: ALLEN NIEDERT DBA NIEDERT CONSTRUCTION AND REMODELING
Bond Amount: $15,000.00
Bond Description: Right of Way Construction
Obligee: City of Waterloo
Gentlemen:
You are hereby notified that the above Bond shall be continued in force for a period effective from
04/30/2019 until 04/30/2020
unless it is cancelled by the surety or otherwise terminated. All other terms and conditions remain
unchanged.
The aggregate liability of the surety shall not exceed the amount of this Continuation Certificate. The
liability of the surety shall not cumulate by reason of this certificate, any continuation certificate, change
rider, endorsement, modification, new bond, reinstatement, reissue, renewal, replacement, or
substitution issued in the future.
Signed this 29th day of March 2019 .
SureTec Insurance Company, Surety
By:
David Gonsa ves
POA it: 3398382
SureTec Insurance Company
LIMITED POWER OF ATTORNEY
Know All Men by These Presents, That SURETEC INSURANCE COMPANY (the "Company"), a corporation duly organized and
existing under the laws of the State of Texas, and having its principal office in Houston, Harris County, Texas, does by these presents
make, constitute and appoint David Gonsalves
its true and lawful Attorney-in-fact, with full power and authority hereby conferred in its name, place and stead, to execute, acknowledge
and deliver any and all bonds, recognizances, undertakings or other instruments or contracts of suretyship to include waivers to the
conditions of contracts and consents of surety for:
Principal: ALLEN NIEDERT DBA NIEDERT CONSTRUCTION AND REMODELING
Obligee: City of Waterloo
Amount: $15,000.00
and to bind the Company thereby as fully and to the same extent as if such bond were signed by the President, sealed with the corporate
seal of the Company and duly attested by its Secretary, hereby ratifying and confirming all that the said Attorney -in -Fact may do in the
premises. Said appointment is made under and by authority of the following resolutions of the Board of Directors of the SureTec
Insurance Company:
Be it Resolved, that the President, any Vice -President, any Assistant Vice -President, any Secretary or any Assistant Secretary shall be and is
hereby vested with full power and authority to appoint any one or more suitable persons as Attorney(s)-in-Fact to represent and act for and on
behalf of the Company subject to the following provisions:
Attorney -in -Fact may be given full power and authority for and in the name of and of behalf of the Company, to execute, acknowledge and
deliver, any and all bonds, recognizances, contracts, agreements or indemnity and other conditional or obligatory undertakings and any and all
notices and documents canceling or terminating the Company's liability thereunder, and any such instruments so executed by any such
Attorney -in -Fact shall be binding upon the Company as if signed by the President and sealed and effected by the Corporate Secretary.
Be it Resolved, that the signature of any authorized officer and seal of the Company heretofore or hereafter affixed to any power of attorney or
any certificate relating thereto by facsimile, and any power of attorney or certificate bearing facsimile signature or facsimile seal shall be valid
and binding upon the Company with respect to any bond or undertaking to which it is attached. (Adopted at a meeting held on 20th of April,
1999)
In Witness Whereof, SURETEC INSURANCE COMPANY has caused these presents to be signed by its President, and its corporate seal
to be hereto affixed this 6th day of April, A.D. 2017.
w;w
State of Texas ss: ;`t,
County of Harris • ,
On this 6th day of April, A.D. 2017 before me personally came John Knox, Jr., to me known, who, being by me . ly sworn, did depose and say, that he
resides in Houston, Texas, that he is President of SURETEC INSURANCE COMPANY, the company descrt.ed in and which executed the above
instrument; that he knows the seal of said Company; that the seal affixed to said instrument is such corporate seal; that it was so affixed by order of the
Board of Directors of said Company; and that he signed his name thereto by like order.
SURETEC ' ' • Y
By: ..../
John Knox,, - t
Presid
s
Y ... JACQUELYN GREENLEAF
Notary Public, State of Texas
+P; Comm. Expires 05-18-2021
Notary ID 126903029
1, M. Brent Beaty, Assistant Secretary of SURETEC INSURANCE COMP
of a Power of Attorney, executed by said Company, which is still in full
out in the Power of Attorney are in full force and effect.
Jacquelyn Greenleaf, Notary Public
My commission expires May 18, 2021
ANY, do hereby certify that the above and foregoing is a true and correct copy
force and effect; and furthermore, the resolutions of the Board of Directors, set
Given under my hand and the seal of said Company at Houston, Texas this 29th
dayygf Marc
019
, A.D.
M. Brent : eaty, Assistant Secretary
Any instrument issued in excess of the penalty stated above is totally void and without any validity.
For verification of the authority of this power you may call (713) 812-0800 any business day between 8:00 am and 5:00 pm CST.
RIGHT OF WAY CONSTRUCTION BOND
No. RLI0513265
Applicant's Telephone Number: j i - - / 13
KNOW ALL MEN BY THESE PRESENTS:
That (1), (We), B.C. Construction, Inc.
of P.O. Box 594 Cedar Falls , IA
Street
as Principal, and
City State
Old Republic Surety Company
of
445 S Moorland Rd, Suite 200 Brookfield, WI 53005
as Surety, are held and firmly bound unto the City of Waterloo, Black Hawk County, Iowa, in the penal
sum of FIFTEEN THOUSAND DOLLARS ($15,000.00) lawful money of the United States of America,
to the payment of which sum, well and truly to be made, the Principal herein firmly binds (himself)
(herself) (themselves) their heirs, executors and administrators, and the said Surety binds
themselves, their successors, assigns, executors and administrators, jointly and severally, firmly by
these presents.
THE CONDITIONS OF THE ABOVE OBLIGATION ARE SUCH that, by the provisions of the
Ordinances of the City of Waterloo, Iowa, a Surety Bond in the sum of Fifteen Thousand Dollars
($15,000.00) must be filed with the City Clerk/Auditor of the City of Waterloo, Iowa, before one may
engage in construction, reconstruction or excavation in the public right of way in said City.
NOW, THEREFORE, if the above bounden B.C. Construction, Inc. of
P.O. Box 594 Cedar Falls, IA 50613-0027 will faithfully perform any and all duties
and abide by any and all regulations required by said Ordinances regulating the construction,
reconstruction and excavation projects within said City; and if (he), (she), (they) will promptly pay to
said City any and all sums and amounts due or that may become due or owing by reason of or under
said Ordinances; and if (he), (she), (they) will pay all fines imposed upon (him), (her), (them), or a
violation of said Ordinances occurring during the life of this bond; and if (he), (she), (they) will
indemnify and keep the City harmless from all liability for any accident and/or damages arising from
(his), (her), (their) doing, protecting or completing the work, then this obligation to be null and void,
otherwise to remain in full force and effect.
The effective date of this Bond is May 1, 20 19 , through April 30, 20 20
Witness our hands this
PLEASE MAIL TO:
City of Waterloo, Iowa
Engineering Department
715 Mulberry Street
Waterloo, IA 50703
Updated 1-24-00
PLEASE COMPLETE CHECKLIST ON REVERSE SIDE BEFORE SUBMITTING BOND.
25th day of
January , 20 19
B.C. Construction, Inc.
PRINCIPAL
By: \9• Ci,
Printed Name: B.C. Construction, Inc.
Old Republic Surety Company
SURETY
By: e_
Attorney-in-fact
****
* *
OLD REPUBLIC SURETY COMPANY
****
POWER OF ATTORNEY
KNOW ALL MEN BY THESE PRESENTS: That OLD REPUBLIC SURETY COMPANY, a Wisconsin stock insurance corporation, does make, constitute and
appoint:
Elise Faust of Brookfield, WI
its true and lawful Attorney(s)-in-Fact, with full power and authority, not exceeding $10,000,000, for and on behalf of the company as surety, to execute and
deliver and affix the seal of the company thereto (if a seal is required), bonds, undertakings, recognizances or other written obligations in the nature thereof,
(other than bail bonds, bank depository bonds, mortgage deficiency bonds, mortgage guaranty bonds, guarantees of installment paper and note
guaranty bonds, self-insurance workers compensation bonds guaranteeing payment of benefits, asbestos abatement contract bonds, waste
management bonds, hazardous waste remediation bonds or black lung bonds), as follows: Effective Date: 4/30/2019 12:00:00 AM
Bond Number: RLI0513265 Bond Amount: Fifteen Thousand Dollars $15,000.00
Principal Name: B.C. Construction, Inc.
Obligee Name: City of Waterloo Engineering Dept of Waterloo, IA
and to bind OLD REPUBLIC SURETY COMPANY thereby, and all of the acts of said Attomeys-in-Fact, pursuant to these presents, are ratified and confirmed.
This appointment is made under and by authority of the board of directors at a special meeting held on February 18, 1982.
This Power of Attorney is signed and sealed by facsimile under and by the authority of the following resolutions adopted by the board of directors of the OLD
REPUBLIC SURETY COMPANY on February 18,1982.
RESOLVED that the president, any vice president or assistant vice president, in conjunction with the secretary or any assistant secretary, may appoint
attomeys-in-fact or agents with authority as defined or limited in the instrument evidencing the appointment in each case, for and on behalf of the company to
execute and deliver and affix the seal of the company to bonds, undertakings, recognizances, and suretyship obligations of all kinds; and said officers may
remove any such attorney-in-fact or agent and revoke any Power of Attorney previously granted to such person.
RESOLVED FURTHER that any bond, undertaking, recognizance, or suretyship obligation shall be valid and binding upon the Company
(i) when signed by the president, any vice president or assistant vice president, and attested and sealed (if a seal be required) by any secretary or assistant
secretary; or
(ii) when signed by the president, any vice president or assistant vice president, secretary or assistant secretary, and countersigned and sealed (if a seal be
required) by a duly authorized attorney-in-fact or agent; or
(iii) when duly executed and sealed (if a seal be required) by one or more attomeys-in-fact or agents pursuant to and within the limits of the authority
evidenced by the Power of Attomey issued by the company to such person or persons.
RESOLVED FURTHER that the signature of any authorized officer and the seal of the company may be affixed by facsimile to any Power of Attomey or
certification thereof authorizing the execution and delivery of any bond, undertaking, recognizance, or other suretyship obligations of the company; and such
signature and seal when so used shall have the same force and effect as though manually affixed.
IN WITNESS WHEREOF, OLD REPUBLIC SURETY COMPANY has caused these presents to be signed by its proper officer, and its corporate seal to be
affixed this 25th day of January 2019
p
Assistant Secretary
STATE OF WISCONSIN, COUNTY OF WAUKESHA - SS
On this 25th day of January 2019 personally came before me Alan Pavlic
and Jane E. Cherney , to me known to be the individuals and officers of the OLD REPUBLIC SURETY COMPANY
who executed the above instrument, and they each acknowledged the execution of the same, and being by me duly sworn, did severally depose and say: that
they are the said officers of the corporation aforesaid, and that the seal affixed to the above instrument is the seal of the corporation, and that said corporate seal
and their signatures as such officers were duly affixed and subscribed to the said instrument by the authority of the board of directors of said corporation.
0
coOPORArf
SEAL
nn *1111,0"\
OLD REPUBLIC SURETY COMPANY
President
CERTIFICATE
I, the undersigned, assistant secretary of the
Power of Attorney remains in full force and has n
Attorney, are now in force.
0405758
ORSC 22262 (3-06)
ALLIED GENERAL AGENCY CO
coaaoa.rr,
SEAL
Notary Public
My Commission Expires: 09/28/2022
(Expiration of notary's commission does not invalidate this instrument)
OLD REPUBLIC SURETY COMPANY, a Wisconsin corporation, CERTIFY that the foregoing and attached
of been revoked; and furthermore, that the Resolutions of the board of directors set forth in the Power of
Signed and sealed at the City of Brookfield, WI this 25th day of
January 2019
e
Assistant Se ry
creta
RIGHT OF WAY CONSTRUCTION BOND
o.
Applicant's Telephone Number: i — 15 — / 9 5:i
KNOW ALL MEN BY THESE PRESENTS:
That (I), (We), 0 I g;1(Gcutc.
?i1) pe'r-1-1, it 111 ki/LCG44 (....
of ��1D [V I C kt}Ct,C Ct . , LO6 (611) (Pr E G 7
Street City State
as Principal, a ' eairIA-- Y <SlAYf, VLL(.-- of
as Surety, are held and firmly bound unto the City of Wath o, Black Hawk County, Iowa, in the penal
sum of FIFTEEN THOUSAND DOLLARS ($15,000.00) lawful money of the United States of America,
to the payment of which sum, well and truly to be made, the Principal herein firmly binds (himself)
(herself) (themselves) their heirs, executors and administrators, and the said Surety binds
themselves, their successors, assigns, executors and administrators, jointly and severally, firmly by
these presents.
THE CONDITIONS OF THE ABOVE OBLIGATION ARE SUCH that, by the provisions of the
Ordinances of the City of Waterloo, Iowa, a Surety Bond in the sum of Fifteen Thousand Dollars
($15,000.00) must be filed with the City Clerk/Auditor of the City of Waterloo, Iowa, before one may
engage in construction, reconstruction or excavation in the public right of way in said City.
NOW, T R FORE if they above bounden VII ```' l ci pi,f04-(„avlii.--416,6f€U t U � -� will faithful) erformand all duties
YP
and abide by any and all regulations required by said Ordinances regulating the construction,
reconstruction and excavation projects within said City; and if (he), (she), (they) will promptly pay to
said City any and all sums and amounts due or that may become due or owing by reason of or under
said Ordinances; and if (he), (she), (they) will pay all fines imposed upon (him), (her), (them), or a
violation of said Ordinances occurring during the life of this bond; and if (he), (she), (they) will
indemnify and keep the City harmless from all liability for any accident and/or damages arising from
(his), (her), (their) doing, protecting or completing the work, then this obligation to be null and void,
otherwise to remain in full force and effect.
The effective date of this Bond is May 1, 20 I `'1 , through April 30, 20
Witness our hands this 10 day of
PLEASE MAIL TO:
City of Waterloo, Iowa
Engineering Department
715 Mulberry Street
Waterloo, IA 50703
,2019 .
tPRINCIPAL
By:)( 2 A L. r `
hATA, GtA-e.,1
Printed Name:
-y-m-fact
Updated 1-24-00 _ 1,(, 6e—e—
PLEASE COMPLETE C } -I tKLIST ON REVE SIDE BEFORE SUBMITTING BOND.
StateFarm
O
0o
POWER OF ATTORNEY
STATE FARM FIRE AND CASUALTY COMPANY
KNOW ALL PERSONS BY THESE PRESENTS: That STATE FARM FIRE AND CASUALTY COMPANY, an Illinois corporation, with its principal office in
Bloomington, Illinois, does hereby constitute and appoint-
of
ppointof Waterloo, Iowa
Lynn Speed
its true and lawful Attorney(s)-in-Fact, to make, execute, seal
and deliver for, and on its behalf as surety, any and all bonds, undertakings or other writings obligatory in the nature of a bond as follows:
$ 2,500 — License, Permit or Indemnity — Financial Guarantee $100,000 — Administrator, Executor, or Trustee of a decendent's estate
$25,000 — License & Permit — Code Compliance $50,000 — Guardian, Conservator, or Committee
$25,000 — Public Official $25,000 — Receiver
$ 2,500 — Judicial
THIS POWER OF ATTORNEY IS NOT VALID FOR THE EXECUTION OF ANY CONTRACT (CONSTRUCTION OR SUPPLY) BOND - BID,
PERFORMANCE OR PAYMENT.
This appointment is made under and by the authority of a resolution which was passed by the Executive Committee of the Board of
Directors of State Farm Fire and Casualty Company on the 14th day of March, 2018, as is duly authorized by the Board of Directors in Article II,
Section 6 of the By -Laws of the Company, which resolution is:
WHEREAS, the Board desires to delegate the authority to appoint persons as Attorneys -in -Fact for certain bonds, undertakings, or other
writings obligatory in the nature of a bond.
RESOLVED, that any Officer of the Company who works regularly with surety bonds is hereby authorized to appoint and empower any
representative of the Company as Attorney -in -Fact to execute on behalf of the Company any bonds, undertakings, or other writings obligatory in the
nature of a bond, which the Company might execute through its officers. Any said execution of such documents by an Attorney -in Fact shall be as
binding upon the Company as if they had been duly executed and acknowledged by he regularly elected or appointed officers of the Company. Any
Attorney -in -Fact, so appointed, may be removed for good cause and the authority so granted may be revoked as specified in the Power of Attorney.
IN WITNESS THEREOF, STATE FARM FIRE AND CASUALTY COMPANY has caused this instrument to be signed by its Officer, and its
Corporate Seal to be affixed this 14th day of March, 2018.
This APPOINTMENT SHALL CEASE AND TERMINATE AUTOMATICALLY AS OF DECEMBER 31, 2021, UNLESS SOONER REVOKED AS
PROVIDED.
PE AND
SEM&E
rte,
STATE FARM FIRE AND CASUALTY COMPANY
By.
John R. Horton - Assistant Secretary Treasurer
STATE OF ILLINOIS 1,
COUNTY OF McLEAN
On this 14th day of March, 2018, before me personally came John R. Horton to me known, who being duly sworn, did depose and say that he
is Assistant Secretary Treasurer of STATE FARM FIRE AND CASUALTY COMPANY, the corporation described in and which executed the above
instrument; that he knows the seal of said corporation; that the seal affixed to said instrument is such Corporate Seal; and that he executed said
instrument on behalf of the corporation by authority of his office under the By -Laws of said corporation.
OFFICIAL SEAL
Pamela Chancellor
NOTARY PUBLIC - STATE OF ILLINOIS
My Commission Expires August 30, 2021
gaxa, C.10,4_04
Notary Public
My commission expires August 30, 2021
CERTIFICATE
1, the undersigned Assistant Secretary Treasurer of STATE FARM FIRE AND CASUALTY COMPANY, do hereby certify that the original
Power of Attorney of which the foregoing is a true and correct copy, is in full force and effect and has not been revoked and the resolutions as set
forth are now in force.
`FtOr919(1)
Signed and sealed at Bloomington, Illinois. Dated this day of
SEM.
If you have a question concerning the validity of this Power of Attorney, call 309-766-2090.
124061.12 (06-19-2018)
c •
Julia K/inzing- Assistant Secretary Treasurer
RIGHT OF WAY CONSTRUCTION BOND
No.
IA5162189
Applicant's Telephone Number: (319) 830-8024
KNOW ALL MEN BY THESE PRESENTS:
That (I), (We), Joni Steen
of 625 Sherman Avenue Waterloo Iowa
Street
as Principal, and
City State
Merchants Bonding Company (Mutual) of
P.O. Box 14498, Des Moines, IA 50306-3498
as Surety, are held and firmly bound unto the City of Waterloo, Black Hawk County, Iowa, in the penal
sum of FIFTEEN THOUSAND DOLLARS ($15,000.00) lawful money of the United States of America,
to the payment of which sum, well and truly to be made, the Principal herein firmly binds (himself)
(herself) (themselves) their heirs, executors and administrators, and the said Surety binds
themselves, their successors, assigns, executors and administrators, jointly and severally, firmly by
these presents.
THE CONDITIONS OF THE ABOVE OBLIGATION ARE SUCH that, by the provisions of the
Ordinances of the City of Waterloo, Iowa. a Surety Bond in the sum of Fifteen Thousand Dollars
($15,000.00) must be filed with the City Clerk/Auditor of the City of Waterloo, Iowa, before one may
engage in construction, reconstruction or excavation in the public right of way in said City.
NOW, THEREFORE, if the above boundenJoni Steen of
Waterloo, IA will faithfully perform any and all duties
and abide by any and all regulations required by said Ordinances regulating the construction,
reconstruction and excavation projects within said City; and if (he), (she), (they) will promptly pay to
said City any and all sums and amounts due or that may become due or owing by reason of or under
said Ordinances; and if (he), (she), (they) will pay all fines imposed upon (him), (her), (them), or a
violation of said Ordinances occurring during the life of this bond; and if (he), (she), (they) will
indemnify and keep the City harmless from all liability for any accident and/or damages arising from
(his), (her), (their) doing, protecting or completing the work, then this obligation to be null and void,
otherwise to remain in full force and effect.
The effective date of this Bond is May 10, 2019 , through April 30, 2020
Witness our hands this 10th day of
PLEASE MAIL TO:
City of Waterloo, Iowa
Engineering Department
715 Mulberry Street
Waterloo, IA 50703
Updated March 2017
PLEASE COMPLETE CHECKLIST ON REVERSE SIDE BEFORE SUBMITTING BOND.
May 2019
Joni Steen
PRINCIP
B
Printed Name:
Merchants Bonding Company (Mutual)
SURETY
By:
Attorney-in-fact William Warner Jr., Attorney -in -Fact
LP 0467 IA (2/17)
THE FOLLOWING IS A HELPFUL CHECKLIST TO ASSIST THE PRINCIPAL
AND/OR SURETY. THERE MAY BE OTHER ITEMS REQUIRED BY THE SURETY,
WHICH ARE NOT LISTED HERE. BEFORE SUBMITTING THIS RIGHT-OF-WAY
CONSTRUCTION BOND FORM, PLEASE BE SURE THE FOLLOWING ITEMS ARE
COMPLETED:
✓ the correct local telephone number of the principal is included;
v the typewritten name of the principal is the same as the name on the signature
line;
✓ the bond is signed by the principal;
✓ the correct address for the principal is included;
✓ surety's address is correct;
✓ beginning and expiration dates are correct, beginning date on bond may be
changed, all right-of-way construction bonds expire on April 30 of the following
year (i.e. bond written during 2005 shall expire April 30, 2006);
✓ the attached power-of-attorney must be effective prior to, or on, the date the
bond is issued:
✓ attorney-in-fact signing the right-of-way construction bond is listed on the
power-of-attorney; and
• name of attorney-in-fact is typed under the signature line;
✓ once the above -referenced items are completed this form must be submitted to
the City of Waterloo Engineering Department so that it can be forwarded to the
City Council for approval before any permits can be issued. Any items received
in the Engineering Department by 4:00 P.M. on Tuesdays will be placed on the
following Monday's agenda or the next available Council meeting due to a fifth
Monday in a month and/or holidays.
MERCHAN-i\
BONDING COMPANY,
POWER OF ATTORNEY
Know All Persons By These Presents, that MERCHANTS BONDING COMPANY (MUTUAL) and MERCHANTS NATIONAL BONDING, INC.,
both being corporations of the State of Iowa (herein collectively called the "Companies") do hereby make, constitute and appoint, individually,
William Warner Jr.
their true and lawful Attorney(s)-in-Fact, to sign its name as surety(ies) and to execute, seal and acknowledge any and all bonds, undertakings,
contracts and other written instruments in the nature thereof, on behalf of the Companies in their business of guaranteeing the fidelity
of persons, guaranteeing the performance of contracts and executing or guaranteeing bonds and undertakings required or permitted in any
actions or proceedings allowed by law.
This Power -of -Attorney is granted and is signed and sealed by facsimile under and by authority of the following By -Laws adopted by the Board
of Directors of Merchants Bonding Company (Mutual) on April 23, 2011 and amended August 14, 2015 and adopted by the Board of Directors
of Merchants National Bonding, Inc., on October 16, 2015.
"The President, Secretary, Treasurer, or any Assistant Treasurer or any Assistant Secretary or any Vice President shall have power and authority
to appoint Attorneys -in -Fact, and to authorize them to execute on behalf of the Company, and attach the seal of the Company thereto, bonds and
undertakings, recognizances, contracts of indemnity and other writings obligatory in the nature thereof."
"The signature of any authorized officer and the seal of the Company may be affixed by facsimile or electronic transmission to any Power of Attorney
or Certification thereof authorizing the execution and delivery of any bond, undertaking, recognizance, or other suretyship obligations of the
Company, and such signature and seal when so used shall have the same force and effect as though manually fixed."
In connection with obligations in favor of the Florida Department of Transportation only, it is agreed that the power and aut hority hereby given to the
Attorney -in -Fact includes any and all consents for the release of retained percentages and/or final estimates on engineering and construction
contracts required by the State of Florida Department of Transportation. It is fully understood that consenti ng to the State of Florida Department
of Transportation making payment of the final estimate to the Contractor and/or its assignee, shall not relieve this surety company of any of
its obligations under its bond.
In connection with obligations in favor of the Kentucky Department of Highways only, it is agreed that the power and authority hereby given
to the Attorney -in -Fact cannot be modified or revoked unless prior written personal notice of such intent has been given to the Commissioner -
Department of Highways of the Commonwealth of Kentucky at least thirty (30) days prior to the modification or revocation.
In Witness Whereof, the Companies have caused this instrument to be signed and sealed this 10th day of May , 2019 •
. 0....... ••-�-•.
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'C2003 o; : ). 1933 vR By
1.0 `••
•
STATE OF IOWA
MERCHANTS BONDING COMPANY (MUTUAL)
MERCHANTS NATIONAL BONDING, INC.
President
COUNTY OF DALLAS ss.
On this this 10th day of May , 2019 , before me appeared Larry Taylor, to me personally known, who being by me duly sworn
did say that he is President of MERCHANTS BONDING COMPANY (MUTUAL) and MERCHANTS NATIONAL BONDING, INC.; and that the
seals affixed to the foregoing instrument are the Corporate Seals of the Companies; and that the said instrument was signed and sealed in behalf
of the Companies by authority of their respective Boards of Directors.
AUCIA K. GRAM
Commission Number 767430
My Commission Expires
April 1, 2020
Notary Public
(Expiration of notary's commission
does not invalidate this instrument)
I, William Warner, Jr., Secretary of MERCHANTS BONDING COMPANY (MUTUAL) and MERCHANTS NATIONAL BONDING, INC., do hereby
certify that the above and foregoing is a true and correct copy of the POWER-OF-ATTORNEY executed by said Companies, which is still in full
force and effect and has not been amended or revoked.
In Witness Whereof, I have hereunto set my hand and affixed the seal of the Companies on this 10th day of May , 2019 .
••••••q'�,PO A-. .•',NpQ QUA .
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t?: 2003 : �• ••y• 1933 ; •• Secretary
POA 0018 (3/17)
RIGHT OF WAY CONSTRUCTION BOND
No. RL10618722
Applicant's Telephone Number: 3194 jj 4 5R.77
KNOW ALL MEN BY THESE PRESENTS:
That (I), (We), Larry A. Rust DBA Larry and Company, Inc.
of 6500 LaFayette Rd. Raymond , IA
Street City State
as Principal, and Old Republic Surety Company of
445 S Moorland Rd, Suite 200 Brookfield, WI 53005
as Surety, are held and firmly bound unto the City of Waterloo, Black Hawk County, Iowa, in the penal
sum of FIFTEEN THOUSAND DOLLARS ($15,000.00) lawful money of the United States of America,
to the payment of which sum, well and truly to be made, the Principal herein firmly binds (himself)
(herself) (themselves) their heirs, executors and administrators, and the said Surety binds
themselves, their successors, assigns, executors and administrators, jointly and severally, firmly by
these presents.
THE CONDITIONS OF THE ABOVE OBLIGATION ARE SUCH that, by the provisions of the
Ordinances of the City of Waterloo, Iowa, a Surety Bond in the sum of Fifteen Thousand Dollars
($15,000.00) must be filed with the City Clerk/Auditor of the City of Waterloo, Iowa, before one may
engage in construction, reconstruction or excavation in the public right of way in said City.
NOW, THEREFORE, if the above bounden Larry A. Rust DBA Larry and Company, Inc. of
6500 LaFayette Rd. Raymond, IA 50667 will faithfully perform any and all duties
and abide by any and all regulations required by said Ordinances regulating the construction,
reconstruction and excavation projects within said City; and if (he), (she), (they) will promptly pay to
said City any and all sums and amounts due or that may become due or owing by reason of or under
said Ordinances; and if (he), (she), (they) will pay all fines imposed upon (him), (her), (them), or a
violation of said Ordinances occurring during the life of this bond; and if (he), (she), (they) will
indemnify and keep the City harmless from all liability for any accident and/or damages arising from
(his), (her), (their) doing, protecting or completing the work, then this obligation to be null and void,
otherwise to remain in full force and effect.
The effective date of this Bond is May 1, 20 19 , through April 30, 20 20
Witness our hands this 25th day of January , 20 19 .
PLEASE MAIL TO:
City of Waterloo, Iowa
Engineering Department
715 Mulberry Street
Waterloo, IA 50703
Larry A. Rust DBA Larry and Company, Inc.
PRINCIPAL
By:
Printed Name: Larry A. Rust
Old Republic Surety Company
SURETY
By:'
Attorney-in-fact
Updated 1-24-00
PLEASE COMPLETE CHECKLIST ON REVERSE SIDE BEFORE SUBMITTING BOND.
****
* *
OLD REPUBLIC SURETY COMPANY
****
POWER OF ATTORNEY
KNOW ALL MEN BY THESE PRESENTS: That OLD REPUBLIC SURETY COMPANY, a Wisconsin stock insurance corporation, does make, constitute and
appoint: Elise Faust of Brookfield, WI
its true and lawful Attorney(s)-in-Fact, with full power and authority, not exceeding $10,000,000, for and on behalf of the company as surety, to execute and
deliver and affix the seal of the company thereto (if a seal is required), bonds, undertakings, recognizances or other written obligations in the nature thereof,
(other than bail bonds, bank depository bonds, mortgage deficiency bonds, mortgage guaranty bonds, guarantees of installment paper and note
guaranty bonds, self-insurance workers compensation bonds guaranteeing payment of benefits, asbestos abatement contract bonds, waste
management bonds, hazardous waste remediation bonds or black lung bonds), as follows: Effective Date: 4/30/2019 12:00:00 AM
Bond Number: RLI0618722 Bond Amount: Fifteen Thousand Dollars $15,000.00
Principal Name: Larry A. Rust DBA Larry and Company, Inc.
Obligee Name: City of Waterloo Engineering Dept of Waterloo, IA
and to bind OLD REPUBLIC SURETY COMPANY thereby, and all of the acts of said Attomeys-in-Fact, pursuant to these presents, are ratified and confirmed.
This appointment is made under and by authority of the board of directors at a special meeting held on February 18, 1982.
This Power of Attomey is signed and sealed by facsimile under and by the authority of the following resolutions adopted by the board of directors of the OLD
REPUBLIC SURETY COMPANY on February 18,1982.
RESOLVED that the president, any vice president or assistant vice president, in conjunction with the secretary or any assistant secretary, may appoint
attomeys-in-fact or agents with authority as defined or limited in the instrument evidencing the appointment in each case, for and on behalf of the company to
execute and deliver and affix the seal of the company to bonds, undertakings, recognizances, and suretyship obligations of all kinds; and said officers may
remove any such attomey-in-fact or agent and revoke any Power of Attorney previously granted to such person.
RESOLVED FURTHER that any bond, undertaking, recognizance, or suretyship obligation shall be valid and binding upon the Company
(i) when signed by the president, any vice president or assistant vice president, and attested and sealed (if a seal be required) by any secretary or assistant
secretary; or
(ii) when signed by the president, any vice president or assistant vice president, secretary or assistant secretary, and countersigned and sealed (if a seal be
required) by a duly authorized attorney-in-fact or agent; or
(iii) when duly executed and sealed (if a seal be required) by one or more attorneys -in -fact or agents pursuant to and within the limits of the authority
evidenced by the Power of Attorney issued by the company to such person or persons.
RESOLVED FURTHER that the signature of any authorized officer and the seal of the company may be affixed by facsimile to any Power of Attorney or
certification thereof authorizing the execution and delivery of any bond, undertaking, recognizance, or other suretyship obligations of the company; and such
signature and seal when so used shall have the same force and effect as though manually affixed.
IN WITNESS WHEREOF, OLD REPUBLIC SURETY COMPANY has caused these presents to be signed by its proper officer, and its corporate seal to be
affixed this 25th day of January 2019
e
Assistant Secretary
STATE OF WISCONSIN, COUNTY OF WAUKESHA - SS
On this 25th day of January 2019 personally came before me Alan Pavlic
and Jane E. Cherney , to me known to be the individuals and officers of the OLD REPUBLIC SURETY COMPANY
who executed the above instrument, and they each acknowledged the execution of the same, and being by me duly sworn, did severally depose and say: that
they are the said officers of the corporation aforesaid, and that the seal affixed to the above instrument is the seal of the corporation, and that said corporate seal
and their signatures as such officers were duly affixed and subscribed to the said instrument by the authority of the board of directors of said corporation.
SURpT;"',,
coavoa•r.,....,.CO �'
SEAL
IWB, ,1 C
OLD REPUBLIC SURETY COMPANY
President
Al VNott Public
My Commission Expires: 09/28/2022
CERTIFICATEiration Ex of notary's p' commission does not invalidate this instrument)
1, the undersigned, assistant secretary of the OLD REPUBLIC SURETY COMPANY, a Wisconsin corporation, CERTIFY that the foregoing and attached
Power of Attorney remains in full force and has not been revoked; and furthermore, that the Resolutions of the board of directors set forth in the Power of
Attorney, are now in force.
0401914
ORSC 22262 (3-06)
PEOPLES INSURANCE AGENCY, LTD.
GOa00a„r,•
SEAL
Signed and sealed at the City of Brookfield, WI this
25th _ day of January 2019
p
Secretary
O 05/16/2019 8:56 AM 15154620040 4 13192875941 pg 1 of 3
RIGHT OF WAY CONSTRUCTION BOND
No, W150316379
Applicant's Telephone Number: ?,95 C�
KNOW ALL MEN BY THESE PRESENTS:
That (I), (We), Professional Concrete
of 4641 Gilbertvilte Rd
Street
Waterloo , IA
City State
as Principal, and Old Republic Surety Company of
445 S Moorland Rd, Suite 200 Brookfield, WI 53005
as Surety, are held and firmly bound unto the City of Waterloo, Black Hawk County, Iowa, in the penal
sum of FIFTEEN THOUSAND DOLLARS ($15,000.00) lawful money of the United States of America,
to the payment of which sum, well and truly to be made, the Principal herein firmly binds (himself)
(herself) (themselves) their heirs, executors and administrators, and the said Surety binds
themselves, their successors, assigns, executors and administrators, jointly and severally, firmly by
these presents.
THE CONDITIONS OF THE ABOVE OBLIGATION ARE SUCH that, by the provisions of the
Ordinances of the City of Waterloo, Iowa, a Surety Bond in the sum of Fifteen Thousand Dollars
($15,000.00) must be filed with the City Clerk/Auditor of the City of Waterloo, Iowa, before one may
engage in construction, reconstruction or excavation in the public right of way in said City.
NOW, THEREFORE, if the above bounden Professional Concrete of
4641 Gilbervlte Rd Waterloo, IA 50701 will faithfully perform any and all duties
and abide by any and all regulations required by said Ordinances regulating the construction,
reconstruction and excavation projects within said City; and if (he), (she), (they) will promptly pay to
said City any and all sums and amounts due or that may become due or owing by reason of or under
said Ordinances; and if (he), (she), (they) will pay all fines imposed upon (him), (her), (them), or a
violation of said Ordinances occurring during the life of this bond; and if (he), (she), (they) will
indemnify and keep the City harmless from all liability for any accident and/or damages arising from
(his), (her), (their) doing, protecting or completing the work, then this obligation to be null and void,
otherwise to remain in full force and effect.
The effective date of this Bond is May 1, 20 19 , through April 30, 20 20
Witness our hands this 25th day of January , 20 19 .
Professional Concrete
PLEASE MAIL TO:
City of Waterloo, Iowa
Engineering Department
715 Mulberry Street
Waterloo, IA 50703
PRINCIPAL
By:
Printed Name: Profession
oncrete
Old Republic Surety Company
SURETY
By:..
Attorney-in-fact
Updated 1-24-00
PLEASE COMPLETE CHECKLIST ON REVERSE SIDE BEFORE SUBMITTING BOND.
O 05/16/2019 8:56 AM
15154620040
a 13192875941 pg 3 of 3
OLD REPUIILIC SURETY COMPANY
POWER OF ATTORNEY
KNOW ALL MEN BY THESE PRESENTS: That OLD REPUBLIC SURETY COMPANY, a Wisconsin stock insurance corporation, does make, constitute and
appoint: Elise Faust of Brookfield, Wi
its true and lawful Attorney(s)-in-Fact, with full power and authority, not exceeding $10,000,000, for and on behalf of the company as surety, to execute and
deliver and affix the seal of the company thereto (if a seal is required), bonds, undertakings, recognizances or other written obligations in the nature thereof,
(other than bail bonds, bank depository bonds, mortgage deficiency bonds, mortgage guaranty bonds, guarantees of installment paper and note
guaranty bonds, self-insurance workers compensation bonds guaranteeing payment of benefits, asbestos abatement contract bonds, waste
management bonds, hazardous waste remediation bonds or black lung bonds), as follows: Effective Date: 4/30/2019 1200:00 AM
Bond Number: W150316379 Bond Amount: Fifteen Thousand Dollars $15,000.00
Principal Name: Professional Concrete
Obligee Name: City of Waterloo Engineering Dept of Waterloo, IA
and to bind OLD REPUBLIC SURETY COMPANY thereby, and all of the acts of said Attorneys -in -Fact, pursuant to these presents, are ratified and confirmed.
This appointment is made under and by authority of the board of directors at a special meeting held on February 18, 1982.
This Power of Attorney is signed and sealed by facsimile under and by the authority of the following resolutions adopted by the board of directors of the OLD
REPUBLIC SURETY COMPANY on February 18,1982.
RESOLVED that the president, any vice president or assistant vice president, in conjunction with the secretary or any assistant secretary, may appoint
attorneys -in -fact or agents with authority as defined or limited in the instrument evidencing the appointment in each case, for and on behalf of the company to
execute and deliver and affix the seal of the company to bonds, undertakings, recognizances, and suretyship obligations of all kinds; and said officers may
remove any such attomey-in-fact or agent and revoke any Power of Attorney previously granted to such person.
RESOLVED FURTHER that any bond, undertaking, recognizance, or suretyship obligation shall be valid and binding upon the Company
(1) when signed by the president, any vice president or assistant vice president, and attested and sealed (if a seal be required) by any secretary or assistant
secretary; or
(ii) when signed by the president, any vice president or assistant vice president, secretary or assistant secretary, and countersigned and sealed (if a seal be
required) by a duly authorized attorney-in-fact or agent; or
(iii) when duly executed and sealed (if a seal be required) by one or more attorneys -in -fact or agents pursuant to and within the limits of the authority
evidenced by the Power of Attorney issued by the company to such person or persons.
RESOLVED FURTHER that the signature of any authorized officer and the seal of the company may be affixed by facsimile to any Power of Attorney or
certification thereof authorizing the execution and delivery of any bond, undertaking, recognizance, or other suretyship obligations of the company; and such
signature and seal when so used shall have the same force and effect as though manually affixed.
IN WITNESS WHEREOF, OLD REPUBLIC SURETY COMPANY has caused these presents to be signed by its proper officer, and its corporate seal to be
affixed this 25th day of
p
January 2019
Assistant Secretary 0,
STATE OF WISCONSIN, COUNTY OF WAUKESHA - SS
On this 25th day of January 2019 personally came before me Alan Pavtic
and Jane E. Cherney , to me known to be the individuals and officers of the OLD REPUBLIC SURETY COMPANY
who executed the above instrument, and they each acknowledged the execution of the same, and being by me duly sworn, did severally depose and say: that
they are the said officers of the corporation aforesaid, and that the seal affixed to the above instrument is the seal of the corporation, and that said corporate seal
and their signatures as such officers were duly affixed and subscribed to the said instrument by the authority of the board of directors of said corporation.
ter s
g SEAL
OLD REPUBLIC SURETY COMPANY
Xj$'141
President
CERTIFICATE
Notary Public
My Commission Expires: 09/28/2022
(Expiration of notary's commission does not invalidate this instrument)
I, the undersigned, assistant secretary of the OLD REPUBLIC SURETY COMPANY, a Wisconsin corporation, CERTIFY that the foregoing and attached
Power of Attomey remains in full force and has not been revoked; and furthermore, that the Resolutions of the board of directors set forth in the Power of
Attomey, are now in force.
0405139
g SEAL ;iE Signed and sealed at the City of Brookfield, WI this 25th day of
ORSC 22252 (3.06)
SCOTT INSURANCE SERVICES
January 2019
447
Ass,stant Secrefary